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Management of complications from alloplastic implants in rhinoplasty

Ferril, Geoffrey R.a; Wudel, Justin M.a; Winkler, Andrew A.b

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2013 - Volume 21 - Issue 4 - p 372–378
doi: 10.1097/MOO.0b013e3283628e40
FACIAL PLASTIC SURGERY: Edited by Julian M. Rowe-Jones and Travis Tollefson

Purpose of review Alloplasts have long been used in rhinoplasty, but their use remains controversial. Many complications are associated with their implementation in rhinoplasty. This article elucidates these complications and provides recommendations for management.

Recent findings Several recent articles have been published presenting experience and outcomes regarding alloplast use in rhinoplasty. In many of these studies, a specific section has been dedicated to outlining the complications encountered by the authors. Oftentimes, a short summary of the complications and their management is provided. By examining the data from these studies, one can conclude several things about the management of complications involving alloplastic implants in rhinoplasty: each case must be approached on an individual basis; clinical decision-making is dictated by physical exam findings and severity of the complication; removal of the implant must be strongly considered; and revision rhinoplasty after an alloplastic complication usually necessitates an autologous graft.

Summary Alloplasts continue to be a controversial option in rhinoplasty. The surgeon must be cognizant of the risks and benefits of their use. A frank preoperative discussion of possible complications with the patient is important. Additionally, prompt recognition and appropriate management of complications is essential to minimize permanent sequelae.

aDepartment of Otolaryngology, Head and Neck Surgery, University of Colorado School of Medicine

bDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Colorado, Denver, Colorado, USA

Correspondence to Andrew A. Winkler, MD, Department of Otolaryngology, 12631 East 17th Avenue, Mail Stop B-205, Aurora, CO 80045, USA. Tel: +1 303 724 1950; fax: +1 303 724 1961; e-mail: Andrew.Winkler@UCDenver.edu

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins